复元醒脑汤对老年急性脑梗死(风痰瘀阻型)的疗效及对血小板GMP-140、HMGB1和MMP-9的影响

Effects of Fuyuan Xingnao Decoction on Elderly Patients with Acute Cerebral Infarction (Syndrome of Blockade of Wind-Phlegm-Static Blood) and its Effects on Platelet GMP-140, HMGB1 and MMP-9

目的:探讨复元醒脑汤对老年急性脑梗死(风痰瘀阻型)的疗效及对血小板颗粒膜蛋白140(GMP-140)、高迁移率族蛋白1(HMGB1)和基质金属蛋白酶9(MMP-9)的影响。方法:选取2017年5月至2019年3月海口市中医医院收治的老年急性脑梗死且中医证型属于风痰瘀阻型的患者89例,采用随机数字表法分为观察组45例和对照组44例。对照组患者采用单纯西医治疗,观察组患者在对照组的基础上加用复元醒脑汤口服治疗。治疗2周后,比较两组患者GMP-140、血小板活化因子(PAF)、超敏C反应蛋白(hs-CRP)、HMGB1、MMP-9、简易智能精神状态检查量表(mini-mental state examination,MMSE)评分、日常生活能力(activities of daily living,ADL)评分及美国国立卫生院卒中神经功能缺损评分量表(national institutes of health stroke scale,NIHSS)评分的差异。结果:治疗后,观察组患者GMP-140、PAF水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者hs-CRP、HMGB1及MMP-9水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者MMSE评分、ADL评分明显高于对照组,NIHSS评分明显低于对照组,差异均有统计学意义(P<0.05)。观察组患者的总有效率为88.89%(40/45),明显高于对照组的70.45%(31/44),差异有统计学意义(P<0.05)。观察组、对照组患者的不良反应发生率分别为20.00%(9/45)、15.91%(7/44),差异无统计学意义(P>0.05)。结论:复元醒脑汤对老年急性脑梗死(风痰瘀阻型)的疗效较好,可有效减轻炎症反应,促进神经功能修复,安全可靠。

OBJECTIVE: To probe into the efficacy of Fuyuan Xingnao decoction on elderly patients with acute cerebral infarction(syndrome of blockade of wind-phlegm-static blood) and its effects on platelet GMP-140, HMGB1 AND MMP-9. METHODS: Totally 89 elderly patients with acute cerebral infarction(syndrome of blockade of wind-phlegm-static blood) admitted into Haikou Traditional Chinese Medicine Hospital from May 2017 to Mar. 2019 were extracted to be divided into the observation group and the control group via the random number table, with 45 cases in the observation group and 44 cases in the control group. The control group was treated with western medicine alone, while the observation group received Fuyuan Xingnao Decoction on the basis of the control group. After treatment of 2 weeks, differences of GMP-140, platelet activating factor(PAF), hypersensitive C-reactive protein(hs-CRP), HMGB1, MMP-9, mini-mental state examination(MMSE) score, activities of daily living(ADL) score and national institutes of health stroke scale(NIHSS) score of two groups were compared. RESULTS: After treatment, the GMP-140 and PAF level of the observation group was significantly lower than that of the control group, with statistically significant difference(P<0.05). The levels of hs-CRP, HMGB1 and MMP-9 in the observation group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05). The MMSE score and ADL score of the observation group were significantly higher than those of the control group, and the NIHSS score was significantly lower than the control group, with statistically significant difference(P<0.05). The total effective rate of the observation group was 88.89%(40/45), significantly higher than that of the control group(70.45%, 31/44), with statistically significant difference(P<0.05). The incidences of adverse drug reactions in the observation group and the control group were 20.00%(9/45) and 15.91%(7/44), respectively, and the difference was not statistically significant(P>0.05). CONCLUSIONS: The efficacy of Fuyuan Xingnao decoction on elderly patients with acute cerebral infarction(syndrome of blockade of wind-phlegm-static blood) is remarkable, which can effectively reduce the inflammation and promote the regeneration of nerve function with higher safety.